SFD (0004-310)79425 Mandarina
0004-310
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
!,. License # Lic. Class Exp. Date
690645 B MC"
Date Signature of Contractorf
U
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one . of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
( ) I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier INS, COMPANY OFT • Policy No. WDR17M1900
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
/Cede, I shall forthwith comply with thos ")provisions.
m
ate: -;a Applicant Xf-rl4 f.l
V r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
gnature (Owner/Agent)
v BUILDING PERMIT PERMIT{?
1 i
0004-? 5 C9
DATE VALUATION LOT TRACT
S214A&SA0 7 24M-1
JOB SITE
ADDRESS 79-42,s mm"_m
APN
772-060-004
OWNER
CONTRACTOR/DESIGNER/EN INEER
1425 X VNiV..:RWY DRTW
1425 F. U .. Vi TTY DRIVE
PF10, ;ATi3E .AZ 95434
PHOEMX AZ 85034
(602)257.1656 (MLO 4990
USE OF PERMIT
MINGLE FA2. LY DWE'LI..MC1
}
SFD-tAT'd PL, ZR PERMIT DOES NOT INCLUf* 8LOCKWALJ S OR
POOL.'954'o PLAN CHECK FEE REDUCTION FOP, MUI,TIPL& MOUANCE OF
$AME PLAN TY'119.
CUSTOM C0115TRUCTION 7,,S'f"I.00 OF
POACH/PATIO 203.00 SF
OARA GEICARPORT (Sf 11,407.20
1~SUMATMD COST Or' C0N1FTRUCT101q
214,05.411
CONSTRUCTION IEE ) 01.000.41$ -OO ID $1,042.00
PLAN GLIECK FES: 141-000-439-318 ;$214A7
MECHA141CAL VFE 101-000-421.0900 $111.50
ELECTRICAL P E1: 1.01-000-420-000 $159.34
PLUMBING FIER 101.0100.419.000 $190,50
STRO140MOTION FEE -RESID 101-004-7A1-000 $21.49
OKADDIO .FEE. 101.0004 23.000 $20,06
WrVELOPER IMPACT FEE $1,907.00
,ART IN PUBLIC PLACES -, RVUE 701.000-255.OW 137.13
SUB -TOTAL COILIZ.0 UC"T1OW AND PLA14 0110ECK
$'3,693.43
UM PRE -PAID FEES
$0.00
T9fAL IF YOM' >u'US DUEir IftQ W
$3k93 43
RECEIPT
DATE
113Y'
DATE FINALE
INSPECTOR
i e 9
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck —
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation_ _� j _
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS • SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) 07
COMMENTS:
FROM FAX NO. 7605642238 Apr. 24 2001 09:15AM Pl
... . ....... ......
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT
OF
7".7012
INSPECTION REQUEST LINE
777-7153
RJT HOMES LLC
Owner
Contractor ME
RJT E4VESTENTS,!Wfn9,8 2QQ0_
Permit Nurnk*r 0004-310 -=g g-,"-
POST ON JOB IN CONSPICUCMS PEACt""',
INSP.Eg.T.O.A.M. ST SIGN ALL APPLICABLE SPACES
,79.425. AIA.NVARW
JOB ADDRESS
SFD-LOT 2B; PERMIT DOES NOT
INCLUDE BLOCK WALL OR POOL.
TYPE OF INSPECTION
DATE INSP.
FOUNDATION &-SETBACK
0 - I-
FOO'nNG STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
Cd
PRE-GUNITE
00 NOT POUR CONCRETE UNTIL ALL ABOVE WAS BEE SI NED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
kj,, NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TFST
HEATING & VENT - A/C
FIREPLACE
ROOF"""""""
BOND BEAM
O.K. TO WRAP
C -
GROUT 0 4' 0 8'
FRAMING
INSULA71ON
PRE -ROOF
COVER NO WORK UNTIL AB VE HAS BEEN SIGNED
DRYWALL INTERIOR
060L ORE PLASTER
FENCE & GATE
EWESEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
'kL GAS TEST
.....;TING -A/C
HOUSE NUMBERS
Joe COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
-^0 rv-4.;j lov at III nlmh
WCertificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R3
79-425 MANDARINA
Type of Construction:
Owner of Building: RJT INVESTMENTS INC
Building Official
Bldg. Permit No.: 0004-310
Land Use Zone: RL
Address: 1425 E UNIVERSITY DR
City: PHOENIX AZ 85034
By: KIRK KIRKLAND
Date: 4-24-01
POST IN A CONSPICUOUS PLACE